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. 1987;23(Suppl 1):15S–19S. doi: 10.1111/j.1365-2125.1987.tb03118.x

Rationale for combination therapy

L Hansson
PMCID: PMC1386042  PMID: 3555582

Abstract

1 Cardiovascular morbidity and mortality is higher in treated hypertensive patients than in normotensive subjects of the same age, sex and from the same populations.

2 A possible and logical explanation for this could be that arterial pressure in treated hypertensive patients usually is significantly higher than in matched normotensive subjects.

3 For these reasons it would appear logical to identify a therapeutic goal in the treatment of hypertension: to obtain normotensive blood pressure levels.

4 In order to obtain this goal, combined treatment with more than one antihypertensive drug would appear to be required.

5 Therapeutic combinations consisting of an ACE-inhibitor plus a diuretic or an ACE-inhibitor plus a calcium antagonist constitute two examples of antihypertensive drug combinations that would appear to offer potent antihypertensive efficacy and good tolerability.

Keywords: arterial hypertension, drug treatment

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Amery A., Birkenhäger W., Brixko P., Bulpitt C., Clement D., Deruyttere M., De Schaepdryver A., Dollery C., Fagard R., Forette F. Mortality and morbidity results from the European Working Party on High Blood Pressure in the Elderly trial. Lancet. 1985 Jun 15;1(8442):1349–1354. doi: 10.1016/s0140-6736(85)91783-0. [DOI] [PubMed] [Google Scholar]
  2. Andrén L., Svensson A., Hansson L. Captopril or atenolol in essential hypertension. Acta Med Scand Suppl. 1983;677:115–118. doi: 10.1111/j.0954-6820.1984.tb08644.x. [DOI] [PubMed] [Google Scholar]
  3. BJORK S., SANNERSTEDT R., ANGERVALL G., HOOD B. Treatment and prognosis in malignant hypertension: clinical follow-up study of 93 patients on modern medical treatment. Acta Med Scand. 1960 Mar 10;166:175–187. doi: 10.1111/j.0954-6820.1960.tb17368.x. [DOI] [PubMed] [Google Scholar]
  4. Beevers D. G., Johnston J., Devine B. L., Dunn F. G., Larkin H., Titterington D. M. Relation between prognosis and the blood pressure before and during treatment of hypertensive patients. Clin Sci Mol Med Suppl. 1978 Dec;4:333s–336s. doi: 10.1042/cs055333s. [DOI] [PubMed] [Google Scholar]
  5. Gudbrandsson T., Hansson L., Herlitz H., Andrén L. Malignant hypertension--improving prognosis in a rare disease. Acta Med Scand. 1979;206(6):495–499. doi: 10.1111/j.0954-6820.1979.tb13553.x. [DOI] [PubMed] [Google Scholar]
  6. HAMILTON M., THOMPSON E. M., WISNIEWSKI T. K. THE ROLE OF BLOOD-PRESSURE CONTROL IN PREVENTING COMPLICATIONS OF HYPERTENSION. Lancet. 1964 Feb 1;1(7327):235–238. doi: 10.1016/s0140-6736(64)92344-x. [DOI] [PubMed] [Google Scholar]
  7. HARINGTON M., KINCAID-SMITH P., McMICHAEL J. Results of treatment in malignant hypertension: a seven-year experience in 94 cases. Br Med J. 1959 Nov 14;2(5158):969–980. doi: 10.1136/bmj.2.5158.969. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Isles C. G., Walker L. M., Beevers G. D., Brown I., Cameron H. L., Clarke J., Hawthorne V., Hole D., Lever A. F., Robertson J. W. Mortality in patients of the Glasgow Blood Pressure Clinic. J Hypertens. 1986 Apr;4(2):141–156. doi: 10.1097/00004872-198604000-00003. [DOI] [PubMed] [Google Scholar]
  9. Johnston C. I., Arnolda L., Hiwatari M. Angiotensin-converting enzyme inhibitors in the treatment of hypertension. Drugs. 1984 Mar;27(3):271–277. doi: 10.2165/00003495-198427030-00006. [DOI] [PubMed] [Google Scholar]
  10. Samuelsson O. Hypertension in middle-aged men. Management, morbidity and prognostic factors during long-term hypertensive care. Acta Med Scand Suppl. 1985;702:1–79. [PubMed] [Google Scholar]
  11. Staessen J., Fagard R., Lijnen P., Verschueren L. J., Amery A. Double-blind comparison between propranolol and bendroflumethiazide in captopril-treated resistant hypertensive patients. Am Heart J. 1983 Aug;106(2):321–328. doi: 10.1016/0002-8703(83)90199-0. [DOI] [PubMed] [Google Scholar]
  12. Zanchetti A. Angiotensin converting enzyme inhibition in clinical practice. A re-examination of stepped-care: a retrospective and a prospective. J Cardiovasc Pharmacol. 1985;7 (Suppl 1):S126–S131. [PubMed] [Google Scholar]

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